BiMax + Implants (Looking for Advice)

[Vercel]

Hi, i have my first appointment with my Oral and maxillofacial Surgeon in two weeks and would appreciate any Input / suggestions if someone has knowledge.

I'm getting BiMax (BSSO & Le-Fort I (3 Piece Y Cut (Kühle said we need a 3-Piece Le-Fort I on the phone after seeing old X-Rays, i was already at the same Clinic as a child, but my Insurance didn't approve Surgery back then for some reason))) together with a Genioplasty for fucked bite / health reasons (anterior open bite, small overbite and asymmetry and alsp small airway? i dont have a cbct or ct with airway analysis yet, but the airway looks like less than 10mm horizontally in some areas and i do snort sometimes when sleeping on my back, so probably UARs too), but i obviously mostly care about the aesthetic outcome.

The Surgery is covered by insurance now luckily.

My Surgeon (Dr. med. Dr. med. dent. Reinald Kühle) is definitely *aware*, he does custom? (i think they are all custom titanium) facial implants (infraorbital, malar and Jaw angle Implants for sure) together with regular BiMax for some cases.

I saw a post of a guy who got operated by the same surgeon and got Malar and Jaw Angle Implants for free (covered by insurance) together with his BiMax, so if im lucky i can get implants covered by Insurance together with the BiMax.

I asked him on the phone months ago (im not 100% sure if i talked to him or someone else) and asked if Infraorbital Rim Implants are possible and he said "yes, but they are not free".

This guy definitely got Jaw Angle and Malar Implants for free covered by Insurance, i don't know why Infras would cost something while Jaw Angle and Malars are free, makes no sense..

I got a blackpilled Bimax including malar + jaw angle implants for free, Germancels GTFIH

Results first (tried to match the angle): Side: Upper lip, lower jaw and cheeks are still very swollen and jaw implants aren't in yet (surgeon said he adds them after a year so he can adjust the aesthetics better in case the bone doesn't fuse properly). Currently 3 months post-OP...

looksmax.org

But if I would benefit from some Implants, and they aren't too expensive I would pay for them myself.

I was also offered Chin Wing on the phone from the surgeon (Kühle?), he said we can make my jaw more manly, he's definitely blackpilled and most likely deals with people who informed themselves on looksmax forums regularly

I don't know if Chin Wing is good for my case tho (i would have to get two surgerys because i doubt anyone combines BSSO and Chin wing, I don't even think it's possible (maybe if they make the vertical cut for the BSSO a little higher?) but even then probably too risky

And i read that Chin Wing worsens the jaw angle? Mine is already high i think (high gonion angle)

So BSSO + Jaw Angle Implants is probably better

I have like no Chin so a big Genioplasty is definitely happening i think

I attached some photos and a Video, would appreciate it if anyone can tell me if i would profit from certain implants (jaw angle, malar, infraorbitals)?

 

[lurking truecel]

Do the surgeon do jaw widening with bimax ? Do you have any TMJ issues as of now ?

 

[lurking truecel]

Your jaw angle is 126 which isnt to bad but you should not do chin wing

 

[Vercel]

Do the surgeon do jaw widening with bimax ? Do you have any TMJ issues as of now ?

Hey, you mean Jaw Widening through Condylar torquing?

From my understanding it always happens to *some* extend during BSSO when not using Custom Guides & Plates for the BSSO, not sure if he would intentionally torque it outwards - i have to ask.

He only uses Custom Guides & Plates for the Le-Fort I, but not for the BSSO - so it will happen to some extend.

I don't have TMJ (Doctor checked), i only have Clicking / Popping when opening my Mouth.

When i Jutt my lower Jaw forward to intentionally create an Underbite the Clicking / Popping is gone when i open my mouth - so i hope it will be gone after the Surgery.

---

Thanks for answering

 

[NZb6Air]

infras for sure but whether zygos or not (which would allow jaw angles) can't tell cause u're fat af

 

[Vercel]

infras for sure but whether zygos or not (which would allow jaw angles) can't tell cause u're fat af

Hi, thanks for answering.

Yes, i gained a lot of weight in the Video compared to the 1st picture, i don't have a Photo or Video of me from the front when i was lean unfortunately.

Zygo / Malar / Cheek implants generally refer to the same area, right?

Can you explain what you mean by "(which would allow jaw angles)"

Do they depend on each other / is it generally recommended to combine them?

 

[NZb6Air]

Hi, thanks for answering.

Yes, i gained a lot of weight in the Video compared to the 1st picture, i don't have a Photo or Video of me from the front when i was lean unfortunately.

Zygo / Malar / Cheek implants generally refer to the same area, right?

Can you explain what you mean by "(which would allow jaw angles)"

Do they depend on each other / is it generally recommended to combine them?

bizygo width should be bigger than bigonial width

 

[Vercel]

bizygo width should be bigger than bigonial width

Oh, i thought it should ideally be close to 1:1 like in this Picture.

I'm obviously lacking bi-gonial width, that's why the other guy asked if my Surgeon can widen it with Condylar torquing.

 

[NZb6Air]

Oh, i thought it should ideally be close to 1:1 like in this Picture.

I'm obviously lacking bi-gonial width, that's why the other guy asked if my Surgeon can widen it with Condylar torquing.

that's not where his bitemporal and bigonial end at, it's skeletal

u prolly did this mistake too @ronald_2

 

[ronald_2]

that's not where his bitemporal and bigonial end at, it's skeletal
View attachment 3286877

u prolly did this mistake too @ronald_2

That explains why my measurements for both were way above the mean in the chart you posted.

Still I have a too wide jaw at 120mm, the mean being 105. I'm fucked.

 

[Vercel]

that's not where his bitemporal and bigonial end at, it's skeletal
View attachment 3286877

u prolly did this mistake too @ronald_2

Thanks for explaining, yeah 1:1 skeletal would look ridiculous.

Most accurately measured by taking a CBCT or CT then?, i can actually measure myself once i have my Scans since i have access to KLS Martin IPS Case Designer (which is also the same Software my Surgeon / the Hospital uses).

Bizygomatic to Bigonial width ratio of 140 mm to 105 mm from your list translates to a ratio of 1.33:1.

 

[ronald_2]

Thanks for explaining, yeah 1:1 skeletal would look ridiculous.

Most accurately measured by taking a CBCT or CT then?, i can actually measure myself once i have my Scans since i have access to KLS Martin IPS Case Designer (which is also the same Software my Surgeon / the Hospital uses).

Bizygomatic to Bigonial width ratio of 140 mm to 105 mm from your list translates to a ratio of 1.33:1.

Hi. One question. Do you feel your face width is around average or above?

 

[Vercel]

Hi. One question. Do you feel your face width is around average or above?

Hey, if you mean generally then my bi-zygomatic and bi-gonial (or entire face) width (skeletal) is probably in the lower end / average range.

 

[Acromegaly_Chad]

richtiger Talahon

 

[Vercel]

richtiger Talahon

Talahon? Ich bin Polnisch

 

[Underdog9494]

Idk ask @BimaxLaser he's expert

 

[BimaxLaser]

Idk ask @BimaxLaser he's expert

No im not that would be @NZb6Air

 

[Underdog9494]

No im not that would be @NZb6Air

Fake name

 

[Underdog9494]

Kys

 

[BimaxLaser]

Fake name

Just cause i need bimax does not make me an expert

 

[Underdog9494]

Just cause i need bimax does not make me an expert

Jfl kys undying m I'mm going to sleep

 

[BimaxLaser]

Jfl kys undying m I'mm going to sleep

Sleep tight lil nigga

 

[iseeblue9]

Don’t think that bimax will produce some good results with that kinda base
implants? might but more of a hit or miss
Looking forward to your results you’re unique case

 

[Acromegaly_Chad]

Talahon? Ich bin Polnisch

 

[Vercel]

Digga ich war selbst in Polen und habe mehrere Polinnen gefickt, du bist kein Pole.

Vielleicht Zigeuner Pole ja, aber nicht ein Pole in dem Sinne wie du es implizierst.

No front es war eigl einfach nur ne festsellung.

Krasser Typ.

Kommst hier in meinen Thread, nennst mich Talahon und erzählst mir direkt wie viele Polinnen du schon gefickt hast.

Wenn du so ein krasser Typ wärst würdest du hier nicht auf dem Forum mit 2000+ Posts rotten.

 

[Acromegaly_Chad]

Krasser Typ.

Kommst hier in meinen Thread, nennst mich Talahon und erzählst mir direkt wie viele Polinnen du schon gefickt hast.

Wenn du so ein krasser Typ wärst würdest du hier nicht auf dem Forum mit 2000+ Posts rotten.

Mach was du für richtig hältst aber komm dann post OP nicht und sag man hätte dich nicht gewarnt dass man seinen phenotyp in die betrachtung und die OP Ziele mit einbeziehen muss.

Das hat ja nix mit Beleidigung zu tun wir sitzen hier im selben Boot (oder ich tat es bis vor wenigen Monaten).

Talahon ist ein looks failo und wenn du incel bist solltest du daran arbeiten. Talahon ist keine spezifische ethnie oder rasse sondern es ist ein look der durch lifestyle generiert wird und den musst du ändern denn mit dem slickback siehst du nach hardcore talahon aus.

 

[Avertion]

Hi, i have my first appointment with my Oral and maxillofacial Surgeon in two weeks and would appreciate any Input / suggestions if someone has knowledge.

I'm getting BiMax (BSSO & Le-Fort I (3 Piece Y Cut (Kühle said we need a 3-Piece Le-Fort I on the phone after seeing old X-Rays, i was already at the same Clinic as a child, but my Insurance didn't approve Surgery back then for some reason))) together with a Genioplasty for fucked bite / health reasons (anterior open bite, small overbite and asymmetry and alsp small airway? i dont have a cbct or ct with airway analysis yet, but the airway looks like less than 10mm horizontally in some areas and i do snort sometimes when sleeping on my back, so probably UARs too), but i obviously mostly care about the aesthetic outcome.

The Surgery is covered by insurance now luckily.

My Surgeon (Dr. med. Dr. med. dent. Reinald Kühle) is definitely *aware*, he does custom? (i think they are all custom titanium) facial implants (infraorbital, malar and Jaw angle Implants for sure) together with regular BiMax for some cases.

I saw a post of a guy who got operated by the same surgeon and got Malar and Jaw Angle Implants for free (covered by insurance) together with his BiMax, so if im lucky i can get implants covered by Insurance together with the BiMax.

I asked him on the phone months ago (im not 100% sure if i talked to him or someone else) and asked if Infraorbital Rim Implants are possible and he said "yes, but they are not free".

This guy definitely got Jaw Angle and Malar Implants for free covered by Insurance, i don't know why Infras would cost something while Jaw Angle and Malars are free, makes no sense..

I got a blackpilled Bimax including malar + jaw angle implants for free, Germancels GTFIH

Results first (tried to match the angle): Side: Upper lip, lower jaw and cheeks are still very swollen and jaw implants aren't in yet (surgeon said he adds them after a year so he can adjust the aesthetics better in case the bone doesn't fuse properly). Currently 3 months post-OP...

looksmax.org

But if I would benefit from some Implants, and they aren't too expensive I would pay for them myself.

I was also offered Chin Wing on the phone from the surgeon (Kühle?), he said we can make my jaw more manly, he's definitely blackpilled and most likely deals with people who informed themselves on looksmax forums regularly

I don't know if Chin Wing is good for my case tho (i would have to get two surgerys because i doubt anyone combines BSSO and Chin wing, I don't even think it's possible (maybe if they make the vertical cut for the BSSO a little higher?) but even then probably too risky

And i read that Chin Wing worsens the jaw angle? Mine is already high i think (high gonion angle)

So BSSO + Jaw Angle Implants is probably better

I have like no Chin so a big Genioplasty is definitely happening i think

I attached some photos and a Video, would appreciate it if anyone can tell me if i would profit from certain implants (jaw angle, malar, infraorbitals)?

How much is this costing you?

 

[Acromegaly_Chad]

Mach was du für richtig hältst aber komm dann post OP nicht und sag man hätte dich nicht gewarnt dass man seinen phenotyp in die betrachtung und die OP Ziele mit einbeziehen muss.

Das hat ja nix mit Beleidigung zu tun wir sitzen hier im selben Boot (oder ich tat es bis vor wenigen Monaten).

Talahon ist ein looks failo und wenn du incel bist solltest du daran arbeiten. Talahon ist keine spezifische ethnie oder rasse sondern es ist ein look der durch lifestyle generiert wird und den musst du ändern denn mit dem slickback siehst du nach hardcore talahon aus.

ach ja und gewöhne dich dran dass man hier im forum kritik anders äussert.

diese ganze sensible sprachwahl und der ganze müll haben hier keinen platz. Man redet hier von mann zu mann und jeder kennt den ernst der situation, dementsprechend wird man auch nicht geschohnt.

Im übrigen würde ich stark davon abraten dein gesicht hier zu posten.

hast du mal gesehen was für leute sich hier treiben? du willst niemals irl mit diesem forum assoziiert sein.

 

[Vercel]

Talahon ist ein looks failo und wenn du incel bist solltest du daran arbeiten. Talahon ist keine spezifische ethnie oder rasse sondern es ist ein look der durch lifestyle generiert wird und den musst du ändern denn mit dem slickback siehst du nach hardcore talahon aus.

Valide. Alles gut, passt.

Bin hier in Deutschland tatsächlich bisschen am struggeln, denke aber eher, dass es dran liegt, weil ich Pole bin.

Habe in Polen nämlich tatsächlich kaum Probleme - ist auch der Hauptgrund wieso ich wieder nach Polen zurückziehe (kann glücklicherweise Remote arbeiten).

Im übrigen würde ich stark davon abraten dein gesicht hier zu posten.

hast du mal gesehen was für leute sich hier treiben? du willst niemals irl mit diesem forum assoziiert sein.

Ne, tatächlich nicht (ich weiß es nicht).

Bin aber in der glücklichen lage, dass mir das relativ egal sein kann und ich keine probleme bekomme wenn es jemand sieht.

 

[Vercel]

Don’t think that bimax will produce some good results with that kinda base
implants? might but more of a hit or miss
Looking forward to your results you’re unique case

Hi, thanks for answering.

Do you still think i would benefit from a few mm Maxillomandibular advancement (MMA) with some CCW rotation to open my Airway, or could i look worse after the Surgery?

I'm getting Sleep apnea notifications from my Apple Watch and I'm currently in the process of getting a sleep study, would actually do surgery just because of that.

I thought my Occlusal Plane is flat, but the X-Ray wasn't aligned to Frankfort horizontal plane.

This one is is aligned:

 

[iseeblue9]

Hi, thanks for answering.

Do you still think i would benefit from a few mm Maxillomandibular advancement (MMA) with some CCW rotation to open my Airway, or could i look worse after the Surgery?

Yes of course it will benefit but you will have to get the precise measurements and plans because few mm can make up or fuck u up

I'm getting Sleep apnea notifications from my Apple Watch and I'm currently in the process of getting a sleep study, would actually do surgery just because of that.

I thought my Occlusal Plane is flat, but the X-Ray wasn't aligned to Frankfort horizontal plane.

This one is is aligned:

For sleep apnea they usually give big movements thus ending up looking like a dogface which is then compensated by implants but its not always a good choice
varies on patient

 

[sb23]

bizygo width should be bigger than bigonial width

I always heavily disliked faces with bigonials wider than bizygo. Really looks like shit in my opinion.

 

[Vercel]

How much is this costing you?

BiMax is mostly covered by Health Insurance, i think i will have to pay like 1000,00€ - 2000,00€ for the 3D Planning and CT/CBCT Scans since Heath Insurance only covers BiMax without those extras.

I might have to pay for the Implants myself tho (don't know yet), havent spoken with the Surgeon yet, i need to get a Polysomnography (Sleep Study) first.

 

[Vercel]

Mach was du für richtig hältst aber komm dann post OP nicht und sag man hätte dich nicht gewarnt dass man seinen phenotyp in die betrachtung und die OP Ziele mit einbeziehen muss.

Hast du denn einen Thread oder Links wo ich mich darüber informieren kann?

Wissen gute Chiruigen wie Kühle über sowas bescheid und beachten das bei der plannung der OP?

Bzw. soweit ich weiß, macht Kühle das nicht selbst sondern irgendwerlche Techniker erstellen den Plan wenn ich es richtig verstanden habe (zumindest ist das an der Charité so, wurde mir gesagt).

Kühle meinte zu mir am Telefon aber, dass ich gerne beim Plan / den Bewegungen mitreden kann und ich werde sicher noch nach Input fragen und den Plan mehrern zeigen bevor ich mich wirklich operieren lasse.

Ich habe auch noch zeit, weil ich erst eine Zahnspange tragen muss (ich weiß gar nicht, ob Kühle auch Surgery-First macht so wie Ebker von der Charité macht. Wenn ja würde ich das vielleicht in erwägung ziehen (wenn mein Biss dafür denn dafür geeignet ist ) und er dem natürlich zustimmt.

Comprehensive virtual orthognathic planning concept in surgery-first patients - PubMed

The surgery-first concept is becoming increasingly popular in orthognathic surgery since it offers major advantages such as a reduction of treatment duration and an increase in patient satisfaction by eliminating phases of presurgical orthodontic decompensation. Here, we present a novel...

pubmed.ncbi.nlm.nih.gov

---

Das ding ist halt, dass meine Schwester komplett Weiß mit Blonden Haaren und Braunen Augen ist und mein Bruder ist auch Komplett Weiß und hat sogar Blaue Augen.

Meine Familie sieht wirklich null aus wie "Zigeuner Polen" / Roma wie auch immer..

Bei mir ist es einfach so, dass ich sehr schnell Dunkel / Tanned werde wenn ich mich in der Sonne sonne. Mein Brunder wird glaube ich einfach nur Rot...

Talahon ist ein looks failo und wenn du incel bist solltest du daran arbeiten. Talahon ist keine spezifische ethnie oder rasse sondern es ist ein look der durch lifestyle generiert wird und den musst du ändern denn mit dem slickback siehst du nach hardcore talahon aus.

Und ja, Valide.

Sehe so auch nicht mehr aus, war letztes Jahr.

Muss aber honestly sagen, dass ich gar nicht so super schlecht behandelt wurde als ich noch so aussah, weil es halt sehr Gepflegt war.

ach ja und gewöhne dich dran dass man hier im forum kritik anders äussert.

diese ganze sensible sprachwahl und der ganze müll haben hier keinen platz. Man redet hier von mann zu mann und jeder kennt den ernst der situation, dementsprechend wird man auch nicht geschohnt.

Das ist deine Meinung, ich bleibe trotzdem nett und höflich - bin einfach so.

Unter von Mann zu Mann reden verstehe ich was anderes, aber gut.

Bin dankbar für jeden Input den ich bekomme.

---

Mir sofort zu erzählen wie viele Polinnen du schon gefickt hast ist auch keine Kritik - finde das auch ziemlich peinlich.

Wem willst du was beweisen?

Hört sich für so an als wärst du ziemlich verletzt und hast jetzt das Befürfnis zu kompensieren. (was ich tatächlich auch verstehe, ist glaube ich teil der Menschlichen Natur - wir sind alle gleich und fühlen die gleichen Emotionen usw.).

---

Ich struggle in Polen selbst kaum, auch jetzt vor der OP nicht und Date da sogar über Looksmatch.

Ich habe es tatächlich ziemlich gut weil ich Remote Arbeiten kann und wahrscheinlich das Doppelte von nem normalen Polen verdiene und die Mädchen dort sind auch Brutal hübsch während die Typen irgendwie voll am slacken sind (da ist Male Gaze sogar noch öfter anzutreffen, die laufen da teilweise noch mit Glatze und sowas rum) und Geld hat in so slawischen Ländern definiv mehr Impact als in Deutschland.

Bin da ja geboren, spreche also auch fließend Polnisch.

Würde aber auch komplett unabhängig von den Frauen dort wieder zurückziehen, mein Geld ist da mehr wert weil es viel günstiger ist und es ist sicherer (da kannst du auch einfach um 02:00 Nachts als frau noch alleine durch die stadt laufen).

 

[Vercel]

Habe auch endlich Elvanse verschrieben bekommen, bin gespannt wie ich aussehen werde wenn ich LeanMaxxed bin.

Hole mir nächste Woche ein Rezept für die 70mg.

 

[Vercel]

@NZb6Air @iseeblue9

Since you guys seem to be quite knowledgeable, one question:

Orthodontists keep telling me that my Anterior Open Bite is caused by Tongue thrusting (which i agree) but keep referring me to Speech Therapy to learn how to swallow correctly, but i feel like my tongue just doesnt have enough space in my mouth (i have a normal tongue size, not extra large).

I went to Speech Therapy and learned "correct swallowing", but i bet i will get an anterior open bite again without surgery if we fix it with with braces only.

Advancing my Maxilla a little and doing a Segmental Le-Fort I (Y-Cut / 3 Piece) would help create more space for my tongue, right?

I was at the same Clinic / Hospital where Kühle is right now and they did actually plan to perform palatal expansion on me when i was a child, but for some reason Health Insurance said no back then.

This could be done now with a Segmental Le-Fort I, right?

I also have Lip incompetence, which i believe is because i don't really have any support under my lower lip / no pronounced Chin, do you guys think a large Genioplaty would get rid of the Lip incompetence? (i believe so, or at least it makes sense to me) but some Speach Therapist i went to told me it has nothing to do with that and i should go to Speech Therapy again to learn how to correctly close my mouth... JFL


Someone also sent me this:

Induvidual cephalometric assessement

Hasund-Segner analysis:

Harmony box slided to contain all values possibble. Prognath type structure(acute SNBa, higher SNA)

SNA=86° (harmonious) (A-point)

NL-NSL=4,5°(harmonious) (maxillary plane)

SNBa=125°(harmonious) (cranial base flexure)

ML-NSL=34,5°(moderate dispropotion) (mandibular plane)**

SNB=80° (retro positioned)(B-point)*

ML-NL=32°(severely open)(maxillomandibular plane angle)***

The analysis indicates mandibular retrognathia with open bite tendency, growth failure of the ramus-condyle functional unit.

Sassouni plane analysis:

Equal propotional facial structure, convergent planes, except severe divergent mandibular plane. Sassouni Type IV.*

The analysis indicates posterior vertical deficiency, ramus hypoplasia.

Sum: Coincident with the degenerative joint changes seen on the lateral xray and orthopanthogram.

Note: Open bite and hyperdivergent mandible in this facial biotype is extremly rare, suggesting acquired nature.

Xrays: Open bite(dental on maxilla, skeletal on mandible), maladaptation of posterior maxilla dentoalveolar process, missing 2nd lower molars, aberrant root and bone morphology especially in the mandible.

I don't really understand the "Sum: Coincident with the degenerative joint changes seen on the lateral xray and orthopanthogram." part.

The Hospital / Clinic reffered me to prosthetics section and a Doctor there told me i don't have any TMJ Issues, just Clicking / Popping which is gone when i Jutt my lower Jaw Forward..

Some other Orthodontist who is "specialised" in TMJ also told me its impossible to tell from X-Rays...

Im so confused

 

[iseeblue9]

Orthodontists keep telling me that my Anterior Open Bite is caused by Tongue thrusting (which i agree) but keep referring me to Speech Therapy to learn how to swallow correctly, but i feel like my tongue just doesnt have enough space in my mouth (i have a normal tongue size, not extra large).

I went to Speech Therapy and learned "correct swallowing", but i bet i will get an anterior open bite again without surgery if we fix it with with braces only.

Advancing my Maxilla a little and doing a Segmental Le-Fort I (Y-Cut / 3 Piece) would help create more space for my tongue, right?

I was at the same Clinic / Hospital where Kühle is right now and they did actually plan to perform palatal expansion on me when i was a child, but for some reason Health Insurance said no back then.

This could be done now with a Segmental Le-Fort I, right?

Yes

I also have Lip incompetence, which i believe is because i don't really have any support under my lower lip / no pronounced Chin, do you guys think a large Genioplaty would get rid of the Lip incompetence? (i believe so, or at least it makes sense to me) but some Speach Therapist i went to told me it has nothing to do with that and i should go to Speech Therapy again to learn how to correctly close my mouth... JFL

Bimax will but make sure not to over advance(chimplip)

Someone also sent me this:


I don't really understand the "Sum: Coincident with the degenerative joint changes seen on the lateral xray and orthopanthogram." part.

The Hospital / Clinic reffered me to prosthetics section and a Doctor there told me i don't have any TMJ Issues, just Clicking / Popping which is gone when i Jutt my lower Jaw Forward..

then it might be because of the bite your openbite

 

[Vercel]

Yes

Bimax will but make sure not to over advance(chimplip)

then it might be because of the bite your openbite

You think BiMax (Le-Fort I & BSSO) will fix the Lip incompetence without Genio?

I think its mostly because of my Lacking Chin, so Genio would fix it, or not?

 

[iseeblue9]

You think BiMax (Le-Fort I & BSSO) will fix the Lip incompetence without Genio?

I think its mostly because of my Lacking Chin, so Genio would fix it,

Ask your surgeon about that chances but u wont see much changes even lips changing from bimax depends on the previous state of face

 

[Vercel]

Ask your surgeon about that chances but u wont see much changes even lips changing from bimax depends on the previous state of face

Thank you!

Yeah i wont rush the process and will show the Plan to multiple People / Doctors and ask before i actutally go and get Surgery

I need to wear Braces for a while (unless we can do surger-first) and LeanMaxx first anyway, but i finally got prescribed stims for my crippling ADHD - so it should be easy to get lean now.

I don't even really know how i look like when im Lean.

Surgery and Implants are Cope if im not LeanMaxxed

View attachment 3343528

HOLY SHIT, what a ascension...

 

[Vercel]

Do you guys think the Surgeon will allow someone to take a Video of the Surgery / the interesting parts if i ask nicely?

I really want to see how they cut my Maxilla and it drops down

 

[Vercel]

Also, here is another Cephalometric Analysis from a Doctor - not WebCeph

I've seen like 3 cephalometric analysis of my Scans and they all differ slighlty (even between doctors) because it seems like every Doctor sligly positions the points differently.

So ideally the Cephalometric Analysis should be done by the same Doctor Pre and after Surgery, i think?

Does anyone know if 3D Cephalometric Analysis are generally more accurate?

I actually tried 3D Ceph myself in KLS Martin IPS CaseDesigner with some random CT / CBCT Scans and you also have to place Landmarks manually there... So i bet it will differ from Doctor to Doctor or Techncian to Technician (whoever places the Landmarks) even with with 3D Cephalometry...

Isnt there some reliabale Software that does 3D Cephalometry accurately on its own?

KLS Martin should honestly hire me as a software developer so i can work on it - so stupid...

But even WebCeph isnt really accurate i think.

https://www.sciencedirect.com/science/article/pii/S1658361221001645

It should be easier to do relable / automated Landmark Identification with CT / CBCT Scans compared to X-Rays

Does someone know if there is such a Solution already?

IPS CaseDesigner definitely doesn't, i had to place them manually.

 

[Vercel]

I will post again and ask for Advice again once I'm Lean and have my CT/CBCT Scans, really makes little sense to ask about Implant Advice if I'm Fat and don't even know how I look under all the Fat.

Implants can also be inserted in a 2nd Surgery, don't have to do everything at once — someone told me it's even better to do it that way because less risk of infection?

 

[ectomorpher]

I will post again and ask for Advice again once I'm Lean and have my CT/CBCT Scans, really makes little sense to ask about Implant Advice if I'm Fat and don't even know how I look under all the Fat.

Implants can also be inserted in a 2nd Surgery, don't have to do everything at once — someone told me it's even better to do it that way because less risk of infection?

yes, it's better to do everything together because you only have anesthesia once and consequently you have fewer risks in general and you also pay less

 

[Vercel]

yes, it's better to do everything together because you only have anesthesia once and consequently you have fewer risks in general

I don't think its that simple.

Yes, its true that you only have one Anesthesia - but Surgery time will be longer if you do BiMax / TriMax + Implants at once.

More Time under the knife also means more Blood loss and higher Risk of Complications / Infections + Longer recovery

It also depends on the type of Implants i guess, if the Implants are Full Custom then its sureley easier to do BiMax / TriMax + Implants at once but some Surgeons use Implants that can be modified / customized mid Surgery (Titanium Mesh?) - in that case it would prbably be better to wait and Place them in a 2nd Surgery after one Year after all the Swelling is gone / bone has healed for opital asthenic results.

and you also pay less

Valid point if you have to pay for the Surgery yourself - maybe? (Unless the Surgeon removes the Plates in a 2nd Surgery anyway?)

In my case my Surgeon removes the Custom Plates after a year (as far as i know) so there will be another Surgery after one Year anyway where he removes the Plates and where he can simultaneously insert the Implants additionally anyway without much additional Cost.

But some Surgeons actually never remove Plates, some people walk around with Plates in their face all their life.

 

[Vercel]

Yes of course it will benefit but you will have to get the precise measurements and plans because few mm can make up or fuck u up

For sleep apnea they usually give big movements thus ending up looking like a dogface which is then compensated by implants but its not always a good choice
varies on patientView attachment 3329447

Went to the ENT Doctor today and found out i have Deviated Septum which probably causes my breathing problems - so no need for big movements (luckily)?

I will ask for a Septoplasty.

 

[lurking truecel]

Your upper maxilla already looks projected to be fair and your nose is straight, I don't see how you will be able to get much movements ? And your Phil is also quite long which will become even longer with forward movements ? Have you discussed about any movements with a doctor ?

 

[lurking truecel]

And also you are tilting your head up really much in your ct side, so it's not. I mean it's not representable, and also in your other pics aswell.

 

[Vercel]

Your upper maxilla already looks projected to be fair and your nose is straight, I don't see how you will be able to get much movements ? And your Phil is also quite long which will become even longer with forward movements ? Have you discussed about any movements with a doctor ?

Hey, no i havent spoken with Kühle yet, he didn't show up last time.

They told me to go to ENT first to check / diagnose breathing issues and check for sleep apnea and after that i can make an apointment with Kühle.

The ENT Doctor Diagnosed the Deviated Septum today and i got a appointment for a polysomnography (sleep study) in 1 month...

I will probably just call tomorrow and book a appointment with Kühle, don't want to wait any longer.

My breathing problems will probably go away if i loose some weight and get a Septoplasty anyway.

---

Yeah i don't know what im doing honestly - i just want to get rid of this Anterior Open Bite and Lip Incompetence and im trying to make / get the best out of a Free BiMax + Implants (if im lucky) from a great Surgeon

My Insurance only pays for combined treatemnt, meaning i HAVE to get surgery or else they wont pay for anything (not even braces) - only in combination with surgery.

https://looksmax.org/threads/i-got-...le-implants-for-free-germancels-gtfih.855287/

But Kühle did very small movements on this guy too (Lower jaw retracted by 2mm, CCW rotated), so maybe just widen my Maxilla so i have more space for my tongue and advance my Mandible 1 or 2 mm with CCW (since my occlusal plane is defenetely not flat on the FHP aligned x-ray) + Genioplasty?

I have no idea, i wont rush the process and wont do surgery if i look worse after

 

[Vercel]

And also you are tilting your head up really much in your ct side, so it's not. I mean it's not representable, and also in your other pics aswell.

not sure what you mean?